Recent consensus guidelines delineate what appears to be the most successful and cost-effective management of low back pain (LBP), and some recent studies have suggested that better outcomes occur with the least aggressive forms of medical intervention.
The purpose of this study was to describe how practitioners manage new-onset, uncomplicated low back workers'compensation (WC) disability cases.
A sample of cases was randomly selected from a large insurance carrier's national data source.
An effort was made to select only uncomplicated cases, which would be expected to have relatively minimal need for medical intervention.
There was an apparent overuse of diagnostic and treatment modalities.
Diagnostic imaging was overutilized, not only in terms of the number of studies done (65% had plain films, 22% had magnetic resonance imaging scans) but also in the time frame in which they were performed (38% had plain films on the first clinic visit).
Ninety percent received at least one medication, and 38% received more than one prescription for opioid analgesics.
Expensive non-steroidal anti-inflammatory drugs were prescribed more often than acetaminophen (61% versus 6%, respectively).
Sixty-two percent received physical therapy that often included modalities with as yet unproven efficacy. (...)
Mots-clés Pascal : Conduite à tenir, Economie santé, Médecine travail, Dorsalgie, Maladie professionnelle, Homme, Rétrospective, Indemnité dédommagement, Epidémiologie, Etats Unis, Amérique du Nord, Amérique, Soin, Qualité, Contrôle coût, Recommandation, Rachis dorsal, Système ostéoarticulaire pathologie, Rachis pathologie, Rachialgie
Mots-clés Pascal anglais : Clinical management, Health economy, Occupational medicine, Dorsalgia, Occupational disease, Human, Retrospective, Indemnity, Epidemiology, United States, North America, America, Care, Quality, Cost control, Recommendation, Dorsal spine, Diseases of the osteoarticular system, Spine disease, Rachialgia
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0289270
Code Inist : 002B15F. Création : 16/11/1999.